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Death is nothing more than the last moment of dying.
-- Montaigne
There is a time in a patient's life when the pain ceases to be, when the mind slips off into a dreamless state, when the need for food becomes minimal and the awareness of the environment all but disappears into darkness. This is the time when the relatives walk up and down the hospital hallways, tormented by the waiting, not know if they should leave to attend the living or stay to be around for the moment of death. This is the time when it is too late for words, and yet the time when the relatives cry the loudest for help -- with or without words. It is too late for medical interventions (and too cruel, though well meant, when they do occur), but it is also too early for a final separation from the dying. It is the hardest time for the next of kin as he either wishes to take off, to get it over with; or he desperately clings to something that he is in the process of losing forever. It is time for the therapy of silence with the patient and availability for the relatives.
The doctor, nurse, social worker, or chaplain can be of great help during these final moments if they can understand the family's conflicts at this time and help select the one person who feels most comfortable staying with the dying patient. This person then becomes in effect the patient's therapist. Those who feel too uncomfortable can be assisted by alleviating their guilt and by the reassurance that someone will stay with the dying until his death has occurred. They can then return home knowing that the patient did not die alone, yet not feeling ashamed or guilty for having avoided this moment which for many people is so difficult to face.
Those who have the strength and the love to sit with a dying patient in the silence that goes beyond words will know this moment is neither frightening nor painful, but a peaceful cessation of the functioning of the body. Watching a peaceful death of a human being reminds us of a falling star; one of a million lights in a vast sky that flares up for a brief moment only to disappear into the endless night forever.
-- Elisabeth Kubler-Ross, On Death and Dying
The water in a vessel is sparkling; the water in the sea is dark.
The small truth has words that are clear; the great truth has great silence.
-- Rabinadrath Tagore
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